ceruletide and Esophageal-Achalasia

Two approaches of infusion and microtransducer manipulation are available for esophageal manometry. If esophageal peristalsis and relaxation of the lower esophageal sphincter (LES) are diminished, the diagnosis of achalasia can be made. As compared with the infusion method, the microtransducer method requires no perfusion of water and has no limit on posture, allowing successful measurement in an empty esophagus. Thus this method, which allows measurement after feeding and continuous monitoring for 24 hours, seems to be more physiological than the infusion method. With this method, however, peristasis-like contractile waves and relaxation of the LES may be observed in addition to simultaneous contractile waves, even in cases of achalasia. Although methods to observe excessive reactions of the LES often involve a loading test with gastrin or mecolyl in some institutions, a loading test with cerulein is routinely used in our department. In healthy controls, administration of cerulein usually leads to decreased LES pressure, while increased LES pressure is observed in patients with achalasia (paradoxical response).

Topics: Ceruletide; Esophageal Achalasia; Esophagogastric Junction; Humans; Manometry; Transducers

Being more evident that primary achalasia is not confined to the esophagus and that it may involve other organs in the digestive tract, gallbladder emptying was ultrasonographically evaluated in 10 patients affected with primary achalasia and in 10 controls. An intravenous cerulein infusion was used to induce gallbladder contraction. Eight out of 10 achalasic patients had a lower gallbladder emptying, and 6 out of 10 had a markedly delayed gallbladder emptying compared with the controls. Achalasic patients, taken as a whole, showed a significantly lower and delayed mean gallbladder emptying when compared with the controls. Such a finding confirms the possible extra-esophageal extension of primary achalasia. In this study, the hypothesis of impaired cholinergic gallbladder innervation in primary achalasia is discussed.

Topics: Ceruletide; Esophageal Achalasia; Female; Gallbladder; Gallbladder Emptying; Humans; Male; Middle Aged; Time Factors; Ultrasonography

Topics: Adolescent; Adult; Aged; Ceruletide; Esophageal Achalasia; Esophagogastric Junction; Female; Humans; Male; Middle Aged; Muscle Contraction; Muscle Relaxation; Muscle, Smooth; Pressure

Topics: Adolescent; Adult; Ceruletide; Esophageal Achalasia; Esophagogastric Junction; Esophagus; Female; Humans; Male; Manometry; Middle Aged; Pressure; Radiography

Based upon the findings in over 1200 patients, technique, indication and validity of pharmacoradiology in examinations of esophagus, stomach, duodenum, small and large intestine are critically evaluated and summarized. Dosis, effects, side effects and contraindications of the mostly applied pharmaca (Buscopan, Pro-Banthine, Paspertin, Glucagon, Cholecystokinin and Caerulein) are listed. The value of pharmacoradiology of the gastrointestinal tract for clinical roentgenology is stressed.

Topics: Butylscopolammonium Bromide; Ceruletide; Colonic Diseases; Duodenal Diseases; Esophageal Achalasia; Esophageal and Gastric Varices; Esophageal Diseases; Gastrointestinal Diseases; Gastrointestinal Motility; Hernia, Hiatal; Humans; Jejunum; Methods; Radiography; Stomach Diseases

Topics: Animals; Calcitonin; Ceruletide; Cholecystokinin; Dogs; Dose-Response Relationship, Drug; Esophageal Achalasia; Esophagogastric Junction; Gastrins; Gastrointestinal Hormones; Glucagon; Humans; Manometry; Muscle Tonus; Secretin